MercyOne Dubuque Medical Center
250 Mercy Drive, Dubuque, IA · MercyOne · · NPI 1659348506
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Rpr rem hernia init reduce CPT 49550 | $31,776.99 | not published | $0.96 – $7,153.96 | 88 |
| Rubella antibody igg CPT 86762 | $67.60 | $104.00 | $13.94 – $104.00 | 49 |
| Rubeola antibody igg CPT 86765 | $371.80 | $572.00 | $12.48 – $572.00 | 49 |
| Russell viper venom diluted CPT 85613 | $232.05 | $357.00 | $9.28 – $357.00 | 49 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $7,844.35 | $7,844.35 | $33.65 – $7,844.35 | 120 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | $201.50 | $310.00 | $93.79 – $310.00 | 49 |
| Sbrt management CPT 77435 | $2,068.00 | $2,068.00 | $408.96 – $1,856.43 | 768 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $274.30 | $422.00 | $93.79 – $634.00 | 120 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $750.75 | $1,155.00 | $93.79 – $1,155.00 | 49 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $325.00 | $500.00 | $93.79 – $634.00 | 120 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $375.70 | $578.00 | $93.79 – $634.00 | 120 |
| Scan proc cranial extra CPT 61782 | $23,520.25 | not published | $5.19 – $14,101.44 | 89 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $2,514.76 | $3,868.86 | $647.57 – $1,813.91 | 33 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $3,890.57 | not published | $2.46 – $1,858.14 | 87 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $3,856.77 | not published | $2.46 – $1,858.14 | 87 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | $141.05 | $217.00 | $17.69 – $217.00 | 46 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $89.70 | $138.00 | $27.70 – $138.00 | 46 |
| Screening hepatitis c antibody high risk HCPCS G0472 | $45.50 | $70.00 | $25.62 – $93.16 | 49 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | $96.85 | $149.00 | $23.60 – $90.00 | 46 |
| Screening Mammogram CPT 77067 | $290.55 | $447.00 | $81.59 – $447.00 | 49 |
| Screening prostate cancer PSA HCPCS G0103 | $75.40 | $116.00 | $18.92 – $116.00 | 46 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $2,979,158.83 | $4,583,321.28 | $0.01 – $35,034.15 | 120 |
| Scrotal (Testicle) Ultrasound CPT 76870 | $672.10 | $1,034.00 | $93.79 – $1,034.00 | 49 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $194.35 | $299.00 | $106.74 – $299.00 | 33 |
| Sedimentation rate erythrocyte automated CPT 85652 | $29.90 | $46.00 | $2.62 – $46.00 | 49 |
| Self-Care and Home Skills Training (each 15 minutes) CPT 97535 | $1,774.50 | $105.00 | $28.47 – $212.00 | 49 |
| Semen analysis presence/motility CPT 89321 | $41.60 | $64.00 | $11.68 – $64.00 | 49 |
| Semen analysis w/count CPT 89310 | $68.90 | $106.00 | $8.34 – $106.00 | 49 |
| Set radiation therapy field CPT 77280 | $19,449.95 | $1,216.00 | $23.64 – $1,216.00 | 785 |
| Set radiation therapy field CPT 77290 | $1,550.90 | $2,386.00 | $52.19 – $2,386.00 | 785 |
| Sevelamer carbonate 800 mg tablet HCPCS J0601 | $1.50 | $1.50 | $0.30 – $1.50 | 108 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $4,725.71 | $7,270.33 | $260.82 – $730.60 | 33 |
| Sheath laser cavaclear 14f HCPCS C1603 | $5,815.06 | $8,946.25 | $2,373.44 – $6,648.28 | 33 |
| Sho arthrs srg bicp tenodsis CPT 29828 | $29,212.90 | not published | $9.09 – $14,498.57 | 89 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | $28,612.14 | not published | $4.41 – $6,537.75 | 89 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | $26,435.03 | not published | $0.96 – $6,537.75 | 88 |
| Shoe post-op mens m HCPCS L3260 | $42.87 | $65.95 | $0.56 – $2.90 | 41 |
| Shot (Injection into Muscle or Under the Skin) CPT 96372 | $2,380.04 | $154.00 | $3.17 – $2,691.00 | 120 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | $24,101.99 | not published | $0.96 – $14,498.57 | 88 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | $370.50 | $570.00 | $93.79 – $380.00 | 120 |
| Shoulder MRI (with and without contrast) CPT 73223 | $5,964.40 | $9,176.00 | $312.99 – $6,117.00 | 120 |
| Shoulder MRI (with contrast) CPT 73222 | $5,309.20 | $8,168.00 | $703.29 – $5,445.00 | 49 |
| Shoulder MRI (without contrast) CPT 73221 | $4,516.85 | $6,949.00 | $214.06 – $4,633.00 | 49 |
| Shoulder X-ray CPT 73030 | $436.15 | $671.00 | $78.07 – $447.00 | 120 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $42,541.71 | $528.00 | $9.09 – $352.00 | 120 |
| Shrinker prosth above knee HCPCS L8460 | $230.16 | $354.09 | $126.41 – $354.09 | 33 |
| Shrinker prosth below knee HCPCS L8440 | $178.39 | $274.45 | $97.98 – $274.45 | 33 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $3,209.23 | $4,937.28 | $63.76 – $178.61 | 33 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $167.70 | $258.00 | $92.11 – $258.00 | 120 |
| Sickling rbc CPT 85660 | $85.80 | $132.00 | $5.33 – $132.00 | 49 |
| Sigmoidoscopy and biopsy CPT 45331 | $3,261.31 | not published | $2.46 – $1,858.14 | 89 |
| Sigmoidoscopy w/tumr remove CPT 45338 | $6,528.94 | not published | $3.24 – $2,391.00 | 89 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $651.10 | $651.10 | $135.97 – $651.10 | 103 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,593.80 | $2,452.00 | $157.36 – $2,452.00 | 120 |
| Sinus CT scan (with contrast) CPT 70487 | $1,660.10 | $2,554.00 | $157.36 – $2,554.00 | 120 |
| Sinus CT scan (without contrast) CPT 70486 | $1,281.80 | $1,972.00 | $93.79 – $1,972.00 | 49 |
| Sinus X-ray (complete) CPT 70220 | $347.10 | $534.00 | $78.07 – $534.00 | 120 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | $42,938.50 | $42,938.50 | $9,250.00 – $42,938.50 | 104 |
| Skull X-ray (1 to 3 views) CPT 70250 | $183.30 | $282.00 | $93.79 – $282.00 | 120 |
| Skull X-ray (complete) CPT 70260 | $274.30 | $422.00 | $93.79 – $422.00 | 120 |
| Sleep Study (Polysomnography) CPT 95810 | $3,244.80 | $4,992.00 | $76.25 – $4,992.00 | 785 |
| Sleeve fing rolyan med HCPCS L3933 | $37.65 | $57.93 | $20.68 – $57.93 | 33 |
| Sleeve irr assura 1pc disp HCPCS A4397 | $0.65 | $1.00 | $0.36 – $1.00 | 33 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $529.06 | $813.94 | $0.74 – $460.33 | 41 |
| Sling pelv split sam med HCPCS L0621 | $165.55 | $254.70 | $49.36 – $254.70 | 41 |
| Sling suprapubic suburetheral HCPCS C1771 | $9,679.96 | $14,892.24 | $728.90 – $2,041.75 | 33 |
| Sm-153 lexidron ther HCPCS A9604 | $57,456.00 | $57,456.00 | $4,314.91 – $57,456.00 | 104 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $574.60 | $884.00 | $157.36 – $884.00 | 120 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $61.75 | $95.00 | $5.22 – $95.00 | 49 |
| Smear gram stain CPT 87205 | $40.95 | $63.00 | $4.14 – $63.00 | 49 |
| Smear nasal eosinophil CPT 89190 | $27.30 | $42.00 | $5.61 – $42.00 | 49 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $44.20 | $68.00 | $5.80 – $68.00 | 49 |
| Smear wet mount CPT 87210 | $1,496.30 | $53.00 | $5.64 – $53.00 | 49 |
| Sock wool above knee HCPCS L8430 | $158.68 | $244.12 | $87.15 – $244.12 | 33 |
| Sodium 24 hour urine CPT 84300 | $28.60 | $44.00 | $4.91 – $44.00 | 49 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $17,456.75 | $25.00 | $2.28 – $6,477.67 | 120 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $22.50 | $22.50 | $6.25 – $17.50 | 33 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $31,140.57 | $20.00 | $0.71 – $14,498.57 | 120 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $30.00 | $30.00 | $10.71 – $75.00 | 104 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $292.60 | $292.60 | $10.90 – $40.85 | 103 |
| Sodium serum/plasma/whole blood CPT 84295 | $758.55 | $30.00 | $4.66 – $30.00 | 49 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $495.00 | $495.00 | $0.86 – $495.00 | 116 |
| Special physics consult CPT 77370 | $21,743.15 | $1,085.00 | $120.59 – $1,085.00 | 49 |
| Special radiation dosimetry CPT 77331 | $370.50 | $570.00 | $120.59 – $952.00 | 120 |
| Special radiation treatment CPT 77470 | $1,665.95 | $2,563.00 | $495.71 – $2,563.00 | 120 |
| Special teletx port plan CPT 77321 | $683.80 | $1,052.00 | $31.74 – $1,052.00 | 785 |
| Specific gravity body fluid CPT 84315 | $39.00 | $60.00 | $3.18 – $60.00 | 49 |
| Speech and Language Evaluation (comprehensive) CPT 92523 | $290.55 | $447.00 | $137.00 – $447.00 | 49 |
| Speech Therapy Session (one-on-one) CPT 92507 | $256.75 | $395.00 | $72.09 – $395.00 | 49 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $961.35 | $1,479.00 | $528.00 – $1,479.00 | 119 |
| Spine X-ray (single view, one level) CPT 72020 | $42,588.11 | $293.00 | $2.28 – $293.00 | 120 |
| Splint arm vnyl coated padded lft med HCPCS Q4051 | $16.25 | $25.00 | $8.93 – $25.00 | 33 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $43.09 | $66.30 | $5.66 – $29.20 | 41 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $50.38 | $77.51 | $7.66 – $39.50 | 41 |
| Splint finger 4 prong foam sm HCPCS A4570 | $0.55 | $0.85 | $0.24 – $0.67 | 33 |
| Splint finger fold over sm HCPCS L3924 | $0.44 | $0.67 | $0.24 – $0.67 | 33 |
| Splint finger frog med HCPCS L3927 | $0.54 | $0.83 | $0.08 – $0.39 | 41 |
| Splint fing stax assort 1-7in HCPCS Q4049 | $1.04 | $1.60 | $0.57 – $1.60 | 33 |
| Splint func pos polyflex ii med HCPCS L3999 | $33.60 | $51.70 | $10.02 – $51.70 | 41 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $101.18 | $155.66 | $9.37 – $48.35 | 41 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.